Abstract
Background: Scabies is an infectious inflammatory skin disease. Cytokine-mediated inflammatory responses may be one of the pathological mechanisms underlying myocardial infarction. Objective: We explore the association between scabies and subsequent acute myocardial infarction (AMI) and all-cause mortality; Methods: We conducted a nationwide population-based study using data from the National Health Insurance Research Database (NHIRD) in Taiwan. Patients with scabies (n = 30,184) and 120,739 controls without scabies were included. The primary outcomes were incidental AMI and all-cause mortality. Using Cox proportional-hazards regression analysis, we estimated the risk of acute myocardial infarction for the study cohort; Results: The mean age of the study cohort was 51.81 ± 19.89 years. The adjusted sub-distribution hazard ratios (aSHRs) of AMI were 1.214 (95% CI, 1.068–1.381) after adjusting for demographic characteristics, income, OPD utility frequency, days in hospital, co-morbidities, and medication. The adjusted hazard ratio (aHR) of all-cause mortality after adjusting for age, gender, income, OPD utility frequency, days in hospital, co-morbidities, co-medication, and urbanization was 1.612 (95% CI, 1.557–1.669). Conclusions: Our study showed that patients with scabies infestations were at higher risk for subsequent AMI and all-cause mortality.
Highlights
We conducted a nationwide cohort study by mining the National Health Insurance Research Database (NHIRD), which collects beneficiaries’ registration files regarding demographics, all types of medical visits, laboratory tests codes, procedure codes, prescription codes, and diagnostic codes based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)
After age-and sex-matching in a 1:4 ratio, a total of 150,923 patients were enrolled in the study, including 30,184 scabies patients and
After adjusting for age, sex, low income, OPD utility frequency, days in the hospital, co-morbidity, co-medication, and urbanization and using the competing risk model of death, the scabies group had a higher risk of acute myocardial infarction (AMI) in patients aged 65–74 compared with the age-matched group controls
Summary
Highly contagious parasitic disease of the skin caused by Sarcoptes scabiei. I.e., 90–99%, present with pruritis [3]. It decreases the quality of life of infected patients and may lead to secondary infections. Previous studies have identified scabies-related complications, including chronic kidney disease (CKD) and chronic obstructive pulmonary disease (COPD) [2,4,5]. A nationwide study reported an increased risk of stroke in patients with scabies and suggested that this association may be due to immunopathological factors [6]. Scabies is an infectious inflammatory skin disease. Cytokine-mediated inflammatory responses may be one of the pathological mechanisms underlying myocardial infarction
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